ANALYZED EXIT HESI FINAL
EXAM QUESTIONS AND
ANSWERS 2026
A client presents at the ED complaining of a raspy voice, cold intolerance, and fatigue. Lab tests indicate
an elevated TSH and low T3 and T4 levels. After the client is admitted to the telemetry unit, which
intervention is most important for the nurse to implement?
A) Assess for presence of non-pitting edema.
B) Administer the prescribed dose of levothyroxine.
C) Offer additional blankets and a warm drink.
D) Note client's most recent hemoglobin levels. - CORRECT ANSWER -B) Administer the prescribed dose
of levothyroxine.
Rationale: In the negative feedback mechanism of hypothyroidism, a low level of thyroid hormone
stimulates TSH production by the hypothalamus and results in an elevated TSH level, but the thyroid
gland does not respond with adequate production of T3 and T4 to regulate basal metabolic rate. These
serum hormone levels indicate the need to administer supplementary thyroid hormone as soon as
possible to avert possible myxedema coma. Non-pitting edema is seen in chronic hypothyroidism and
assessment of the presence and location of the edema (A) is not a top priority. Providing warmth (C) is
beneficial but of less priority than (B). Anemia is common in hypothyroidism, but (D) is of lower priority
than initiating treatment to prevent myxedema coma.
The nurse suspects that a client might be hemorrhaging internally. Which findings of an orthostatic tilt
test are a most likely indication of a major bleed (> 1000 ml)?
A) A decrease in the systolic BP of 10 mm Hg with a corresponding increase in the HR of 20.
B) A decrease in the systolic BP of 10 mm Hg with a corresponding decrease in the HR of 20.
,C) A mdecrease min mthe msystolic mBP mof m20 mmm mHg mwith ma mcorresponding mdecrease min mthe mHR mof m10. m
D) A mdecrease min mthe msystolic mBP mof m20 mmm mHg mwith ma mcorresponding mincrease min mthe mHR mof m10. m-
mCORRECT mANSWER m-Ans: mA) mA mdecrease min mthe msystolic mBP mof m10 mmm mHg mwith ma mcorresponding
mincrease min mthe mHR mof m
20. m
m
Rationale: mThe mloss mof mcirculatory mvolume mresults min ma m10 mmm mHg mdrop min mthe msystolic mpressure,
mwhile mthe mHR mincreases mby m20 m% mabove mnormal mas ma mcompensatory mresponse mto mthe mlow
mpressure. m
m
When mconducting mdiet mteaching mfor ma mclient mwho mis mon ma mpostoperative mfull mliquid mdiet, mwhich
mfoods mshould mthe mnurse mencourage mthe mclient mto meat? mSATA. m
m
A) Canned mfruit mcocktail m
B) Creamy mpeanut mbutter m
C) Vegetable mjuice m
D) Vanilla mfrozen myogurt m
E) Clear mbeef mbroth m- mCORRECT mANSWER m-Ans: mC, mD, mE m
A mfull mliquid mdiet mincludes mall mliquids mthat mare mnot mclear msuch mas mvegetable mjuice mand mfrozen myogurt,
mas mwell mas mclear mliquids. mPieces mof mfruit mas mfound min mfruit mcocktail mand mpeanut mbutter mare mnot
mconsidered mliquids. m
m
A mclient mis mreceiving mophthalmic mdrops mpreoperatively mfor ma mcataract mextraction mand masks mthe mnurse
mwhy mhe mis mprescribed mall mthese mmedications? mSATA. m
m
A) One mof mthe mmedications mis mused mto manesthetize mthe mcorneal msurface. m
B) The miris mmust mbe mparalyzed mduring mthe msurgery mto mprevent mit mfrom mreacting mto mlight. m
C) Medication mis mused mto minduce msleep mduring mthe mprocedure. m
D) Pupillary mdilation mis mnecessary mto maccess mthe meye mchamber mfor mlens mremoval. m
E) These mmeds massist min mobstructing mthe mclient's mvision mduring mthe msurgery. m- mCORRECT mANSWER m-
Ans: mA, mB, mD m
,Cataract msurgery mis maccessed mthrough mthe mcornea musing meyelid mretractors mwhile mthe mclient mis mawake.
mIt mis mnecessary mto manesthetize mthe mcorneal msurface m(A), mparalyze mthe mciliary mbody m(B), mand mprovide
mpupil mdilation m(D)(mydriasis) mto mfacilitate maccess mto mthe mlens mwhich mties mbehind mthe miris m(posterior
mchamber mof mthe manterior mcavity). mA msedative mmay mbe madministered mto mreduce manxiety mbut mit mis mnot
mused mto minduce msleep. m(C) mCloudy mvision mmay mbe ma mside meffect mof mthese magents, mbut mthe mclient mwill
mstill mbe mable mto msee mduring mthe msurgery m(E). m
m
When massessing man mIV msite mthat mis msued mfor mfluid mreplacement mand mmedication madministration, mthe
mclient mcomplains mof mthe mtenderness mwhen mthe marm mis mtouched mabove mthe msite. mWhich madditional
massessment mwarrants mimmediate mintervention mby mthe mnurse? m
m
A) Sluggish mblood mreturn m
B) Client muses mthe marm mcautiously m
C) Spot mof mdried mblood mat mthe minsertion msite m
D) Red mstreak mtracking mthe mvein m- mCORRECT mANSWER m-Ans: mD m
A mred mstreak m(D) mindicates mvein mirritation mand mnecessitates mdiscontinuing mthe mIV mat mthe mpresent msite.
mA, mB, mand mC mare mindications mfor mrelocating mthe mIV msite mor mother mimmediate mintervention. m
m
A mclient mwith ma mliver mabscess mdevelops mseptic mshock. mA msepsis mresuscitation mbundle mprotocol mis
minitiated mand mthe mclient mreceives ma mbolus mof mIV mfluids. mWhich mparameter mshould mthe mnurse mmonitor
mto massess meffectiveness mof mthe mfluid mbolus? m
m
A) Blood mcultures. m
B) Oxygen msaturation. m
C) White mblood mcount. m
D) Mean marterial mpressure m(MAP). m- mCORRECT mANSWER m-D) mMean marterial mpressure m(MAP) m
m
The mcornerstone mof minitial msepsis mresuscitation mis mfluid mvolume madministration mto mrestore mand mthen
mmaintain mMAP mof mat mleast m65 mmmHg. m
m
When mattempting mto mestablish mrisk mreduction mstrategies min ma mcommunity, mthe mnurse mnotes mthat
mregional mstudies mindicate ma mhigh mnumber mof mpersons mwith mgrowth mstunting mand mirreversible mmental
, m deficiencies m(cretinism) mcaused mby mhypothyroidism. mThe mnurse mshould mseek mfunding mto mimplement
m which mscreening mmeasure? m
m
A)T4 mlevels min mnewborns. m
B) TSH mlevels min mwomen mover m45. m
C) T3 mlevels min mschool-aged mchildren m
D) Iodine mlevels min mall mpersons mover m60. m- mCORRECT mANSWER m-A) mT4 mlevels min mnewborns. m m
m
Screening mfor mlow mT4 mlevels min mnewborns mwith mfollow-up mtreatment mcan mreduce mthe mrisk mfor
mirreversible mgrowth mstunting mand mmental mdeficiencies mcaused mby mcongenital mhypothyroidism. m
m
For mthe mpast m24 mhours, man mantidiarrheal magent, mdiphenoxylate, mhas mbeen madministered mto ma
mbedridden, molder mclient mwith minfectious mgastroenteritis. mWhich mfinding mrequires mthe mnurse mto mtake
mfurther maction? m
m
A) Loss mof mappetite m
B) Serum mK+ m4.0 mmEq/L mor mmmol/L m(SI) m
C) Loose, mrunny mstools. m
D) Tented mskin mturgor. m- mCORRECT mANSWER m-D) mTented mskin mturgor. m
Indicates mdehydration, ma mserious mcomplication mfollowing mprolonged mdiarrhea mthat mrequires mfurther
mintervention mby mthe mnurse. m
m
A mmale mclient mwith mulcerative mcolitis mreceived man mRx mfor ma mcorticosteroid mlast mmonth mbut mbecause mof
mthe mS/E, mhe mstopped mtaking mthe mmedications m6 mdays mago. mWhich mfinding mwarrants mimmediate
mintervention mby mthe mnurse? m
m
A) Fluid mretention m
B) Hypotension mand mfever m
C) Anxiety mand mrestlessness m
D) Increased mblood mglucose m- mCORRECT mANSWER m-B) mHypotension mand mfever m
EXAM QUESTIONS AND
ANSWERS 2026
A client presents at the ED complaining of a raspy voice, cold intolerance, and fatigue. Lab tests indicate
an elevated TSH and low T3 and T4 levels. After the client is admitted to the telemetry unit, which
intervention is most important for the nurse to implement?
A) Assess for presence of non-pitting edema.
B) Administer the prescribed dose of levothyroxine.
C) Offer additional blankets and a warm drink.
D) Note client's most recent hemoglobin levels. - CORRECT ANSWER -B) Administer the prescribed dose
of levothyroxine.
Rationale: In the negative feedback mechanism of hypothyroidism, a low level of thyroid hormone
stimulates TSH production by the hypothalamus and results in an elevated TSH level, but the thyroid
gland does not respond with adequate production of T3 and T4 to regulate basal metabolic rate. These
serum hormone levels indicate the need to administer supplementary thyroid hormone as soon as
possible to avert possible myxedema coma. Non-pitting edema is seen in chronic hypothyroidism and
assessment of the presence and location of the edema (A) is not a top priority. Providing warmth (C) is
beneficial but of less priority than (B). Anemia is common in hypothyroidism, but (D) is of lower priority
than initiating treatment to prevent myxedema coma.
The nurse suspects that a client might be hemorrhaging internally. Which findings of an orthostatic tilt
test are a most likely indication of a major bleed (> 1000 ml)?
A) A decrease in the systolic BP of 10 mm Hg with a corresponding increase in the HR of 20.
B) A decrease in the systolic BP of 10 mm Hg with a corresponding decrease in the HR of 20.
,C) A mdecrease min mthe msystolic mBP mof m20 mmm mHg mwith ma mcorresponding mdecrease min mthe mHR mof m10. m
D) A mdecrease min mthe msystolic mBP mof m20 mmm mHg mwith ma mcorresponding mincrease min mthe mHR mof m10. m-
mCORRECT mANSWER m-Ans: mA) mA mdecrease min mthe msystolic mBP mof m10 mmm mHg mwith ma mcorresponding
mincrease min mthe mHR mof m
20. m
m
Rationale: mThe mloss mof mcirculatory mvolume mresults min ma m10 mmm mHg mdrop min mthe msystolic mpressure,
mwhile mthe mHR mincreases mby m20 m% mabove mnormal mas ma mcompensatory mresponse mto mthe mlow
mpressure. m
m
When mconducting mdiet mteaching mfor ma mclient mwho mis mon ma mpostoperative mfull mliquid mdiet, mwhich
mfoods mshould mthe mnurse mencourage mthe mclient mto meat? mSATA. m
m
A) Canned mfruit mcocktail m
B) Creamy mpeanut mbutter m
C) Vegetable mjuice m
D) Vanilla mfrozen myogurt m
E) Clear mbeef mbroth m- mCORRECT mANSWER m-Ans: mC, mD, mE m
A mfull mliquid mdiet mincludes mall mliquids mthat mare mnot mclear msuch mas mvegetable mjuice mand mfrozen myogurt,
mas mwell mas mclear mliquids. mPieces mof mfruit mas mfound min mfruit mcocktail mand mpeanut mbutter mare mnot
mconsidered mliquids. m
m
A mclient mis mreceiving mophthalmic mdrops mpreoperatively mfor ma mcataract mextraction mand masks mthe mnurse
mwhy mhe mis mprescribed mall mthese mmedications? mSATA. m
m
A) One mof mthe mmedications mis mused mto manesthetize mthe mcorneal msurface. m
B) The miris mmust mbe mparalyzed mduring mthe msurgery mto mprevent mit mfrom mreacting mto mlight. m
C) Medication mis mused mto minduce msleep mduring mthe mprocedure. m
D) Pupillary mdilation mis mnecessary mto maccess mthe meye mchamber mfor mlens mremoval. m
E) These mmeds massist min mobstructing mthe mclient's mvision mduring mthe msurgery. m- mCORRECT mANSWER m-
Ans: mA, mB, mD m
,Cataract msurgery mis maccessed mthrough mthe mcornea musing meyelid mretractors mwhile mthe mclient mis mawake.
mIt mis mnecessary mto manesthetize mthe mcorneal msurface m(A), mparalyze mthe mciliary mbody m(B), mand mprovide
mpupil mdilation m(D)(mydriasis) mto mfacilitate maccess mto mthe mlens mwhich mties mbehind mthe miris m(posterior
mchamber mof mthe manterior mcavity). mA msedative mmay mbe madministered mto mreduce manxiety mbut mit mis mnot
mused mto minduce msleep. m(C) mCloudy mvision mmay mbe ma mside meffect mof mthese magents, mbut mthe mclient mwill
mstill mbe mable mto msee mduring mthe msurgery m(E). m
m
When massessing man mIV msite mthat mis msued mfor mfluid mreplacement mand mmedication madministration, mthe
mclient mcomplains mof mthe mtenderness mwhen mthe marm mis mtouched mabove mthe msite. mWhich madditional
massessment mwarrants mimmediate mintervention mby mthe mnurse? m
m
A) Sluggish mblood mreturn m
B) Client muses mthe marm mcautiously m
C) Spot mof mdried mblood mat mthe minsertion msite m
D) Red mstreak mtracking mthe mvein m- mCORRECT mANSWER m-Ans: mD m
A mred mstreak m(D) mindicates mvein mirritation mand mnecessitates mdiscontinuing mthe mIV mat mthe mpresent msite.
mA, mB, mand mC mare mindications mfor mrelocating mthe mIV msite mor mother mimmediate mintervention. m
m
A mclient mwith ma mliver mabscess mdevelops mseptic mshock. mA msepsis mresuscitation mbundle mprotocol mis
minitiated mand mthe mclient mreceives ma mbolus mof mIV mfluids. mWhich mparameter mshould mthe mnurse mmonitor
mto massess meffectiveness mof mthe mfluid mbolus? m
m
A) Blood mcultures. m
B) Oxygen msaturation. m
C) White mblood mcount. m
D) Mean marterial mpressure m(MAP). m- mCORRECT mANSWER m-D) mMean marterial mpressure m(MAP) m
m
The mcornerstone mof minitial msepsis mresuscitation mis mfluid mvolume madministration mto mrestore mand mthen
mmaintain mMAP mof mat mleast m65 mmmHg. m
m
When mattempting mto mestablish mrisk mreduction mstrategies min ma mcommunity, mthe mnurse mnotes mthat
mregional mstudies mindicate ma mhigh mnumber mof mpersons mwith mgrowth mstunting mand mirreversible mmental
, m deficiencies m(cretinism) mcaused mby mhypothyroidism. mThe mnurse mshould mseek mfunding mto mimplement
m which mscreening mmeasure? m
m
A)T4 mlevels min mnewborns. m
B) TSH mlevels min mwomen mover m45. m
C) T3 mlevels min mschool-aged mchildren m
D) Iodine mlevels min mall mpersons mover m60. m- mCORRECT mANSWER m-A) mT4 mlevels min mnewborns. m m
m
Screening mfor mlow mT4 mlevels min mnewborns mwith mfollow-up mtreatment mcan mreduce mthe mrisk mfor
mirreversible mgrowth mstunting mand mmental mdeficiencies mcaused mby mcongenital mhypothyroidism. m
m
For mthe mpast m24 mhours, man mantidiarrheal magent, mdiphenoxylate, mhas mbeen madministered mto ma
mbedridden, molder mclient mwith minfectious mgastroenteritis. mWhich mfinding mrequires mthe mnurse mto mtake
mfurther maction? m
m
A) Loss mof mappetite m
B) Serum mK+ m4.0 mmEq/L mor mmmol/L m(SI) m
C) Loose, mrunny mstools. m
D) Tented mskin mturgor. m- mCORRECT mANSWER m-D) mTented mskin mturgor. m
Indicates mdehydration, ma mserious mcomplication mfollowing mprolonged mdiarrhea mthat mrequires mfurther
mintervention mby mthe mnurse. m
m
A mmale mclient mwith mulcerative mcolitis mreceived man mRx mfor ma mcorticosteroid mlast mmonth mbut mbecause mof
mthe mS/E, mhe mstopped mtaking mthe mmedications m6 mdays mago. mWhich mfinding mwarrants mimmediate
mintervention mby mthe mnurse? m
m
A) Fluid mretention m
B) Hypotension mand mfever m
C) Anxiety mand mrestlessness m
D) Increased mblood mglucose m- mCORRECT mANSWER m-B) mHypotension mand mfever m
